Harvester

I enjoyed the 2nd Twitter journal club (see @twitjournal club, #twitjc and www.twitjc@wordpress.com). This is a great idea, bringing doctors from very many specialities together to discuss papers of general interest. It has similar aims to my critical appraisal site at www.criticalinisght.wordpress.com, although obviously a much wider spectrum. The discussion around the paper was wide ranging, and it was great to see experts, novices, students, PAMs and generalists all getting involved.

Some might say that Twitter doesn’t lend itself to indepth analysis of carefully organised and rigorous critical appraisal (see here). That’s true, but the ability of individuals to make comments, have discussions amongst themselves, choose the direction and suggest further reading, links etc adds a new dimension. I think there is room for both. It can be difficult to follow everything that is said, but I would suggest a different approach. Imagine a conference hall all discussing different aspects of a presentation, if you were there in person you could participate in only one discussion. With twitter you’re aware of them all, and participate or just listen. There’s no need to feel you need to read every single tweet, like you wouldn’t expect to hear every single sentence in the hall. Instead important messages and conclusions will tend to be reached by multiple different people over time and “rise to the top” .

I think the introduction to the paper provided at the blog, and the follow up summaries can help bring home the learning points, and having an acknowledged expert in the field involved can certainly help avoid factual errors or misinterpretation. It will evolve over time and the biggest threat is probably its own popularity. If it’s difficult to follow with 100 people involved, with a 1000 it might be impossible. At that point it could divide by speciality, but I think we might miss the views of those we hear less often within the silos of our own specialities!

The Royal Society have launched a working group looking at the system that governs sharing of scientific data. The current system lends itself to positive bias, rejects new ideas and limits quick and constructive peer analysis. This holds back the sum total of what we can achieve, but protects careers and investments (which is important). A new mechanism for measuring the impact of research other than citation might help (see here). This is a pressing problem, I’m looking forward to reading their suggestions.

An outstanding piece of writing in the London Review of Books here The author having undergone major surgery develops complications. Whilst describing her hallucinations, failed analgesia and intermittent care she reminds us of the tiny things that can matter so much to a sick patient. Narrative accounts such as these have a the potential to make lasting changes to behaviour, attitudes and thus outcomes. There is more to medicine than p < 0.05.

A simple idea – a place to collect & share articles that spark my interest encourage co-operation between disciplines add to the library of human understanding there might be the odd bit of thought of my own as well from time to time.